Kyle Louis Bouhana, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901020981 Issued in MI

Practice address

11479 Highland Rd
Hartland, MI 48353-2737

Phone

(810) 632-9088

NPI assigned

Jun 2, 2013

Last updated

Jun 2, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370131200000",
    "number": "1912344847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 GUTHRIE AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673527",
            "telephone_number": "810-923-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11479 HIGHLAND RD",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532737",
            "telephone_number": "810-632-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUHANA",
        "first_name": "KYLE",
        "middle_name": "LOUIS",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-02",
        "last_updated": "2013-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Blanchard, DPT
• Jordyn Bliss
• Paige Autumn Bolton
• Kylie Bomers
• Kristine Marie Bonn, O.T.R.
• Thomas Louis Bouhana, D.D.S.
• Marnie Beth Bradin, MPT
• Lance Brooks
• Sterling Noelle Brown, AUD
• Bruce Terrio MD, PC

• General Practice Dentistry in Hartland, MI
• Providers in Hartland, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.